대한대장항문학회

The general incidence of tuberculosis in Korea has shown sharp decline with<br>improvement of public hygiene and nutritional status, but still many patients are<br>suffered from pulmonary tuberculosis and that of other organs. Especially, tuberculous<br>fistula-in-ano is relatively rare that only a few reports have been reported in the<br>literature. In 1988, the authors reported a study of 10 cases of tuberculous origin out of<br>88 ordinary fistula-in-anos(11.3%) in a 3-year period. Consecutively, of 174 patients<br>with fistula-in-ano operated upon in a following 6-year period, 22 cases(12.6%) were<br>newly diagnosed as tuberculous fistula-in-ano on the histopathological<br>examination.<br>These conclusions were based on results obtained in treating cumulative 32 cases and<br>results were as follows;<br>1) Of the total 262 fistula-in-anos, 32 cases(12.2%) were tuberculous(20 cases;<br>fistula-in-ano, 12 cases: perianal abscess).<br>2) Sex ratio was 7：1, of male preponderance.<br>3) The most prevalent age group was 4th decade(40.7%).<br>4) Pulmonary tuberculosis was co-existed in 13 cases(40.6%).<br>5) The 12 patients(37.5%) were previously operated upon perianal abscess<br>or<br>fistula-in-ano at the other clinics.<br>6) The accompanying anal lesions were perianal abscesses(12 cases)<br>and<br>hemorrhoids(6 cases).<br>7) The intersphincteric type was predominant in 13 cases(40.6%), suprasphincteric 9<br>case(28.2%), transsphincteric 7 cases(21.9%), extrasphincteric 3 cases(9.3%) in order.<br>8) Operative procedures included fistulectomy(21 cases), fistulotomy and laying open(10<br>cases) and Hartmann colostomy(1 case).<br>9) All patients was treated with postoperative antituberculosis regimen, isoniazid,<br>rifampicin, ethambutol(or pyrazinamide) for 6∼12 months.<br>10) The 3 cases(9.4%) were recurred, in which follow up care was discontinued by<br>themselves.<br>